急性ST段抬高型心肌梗死患者PCI术后无复流现象的研究进展

冠状动脉粥样硬化性心脏病是全球范围内心血管疾病患者死亡的主要原因,其中以急性ST段抬高型心肌梗死(STEMI)最为凶险。及时经皮冠状动脉介入治疗(PCI)是目前急性STEMI患者最主流的再灌注策略。而部分患者在PCI术后仍不能得到充分的血液灌注,即出现无复流现象(NRP),与随后的不良临床预后密切相关。因此,为了有效恢复再灌注后冠状动脉微循环的血流,防治冠状动脉NRP的发生就显得尤为重要。本文回顾NRP的定义、诊断和临床表现,以病理生理机制为桥梁,提出通过相关预测因子来选择防治策略从而提高PCI疗效。

Research progress of no-reflow phenomenon after PCI in patients with acute ST-segment elevation myocardial infarction

Coronary atherosclerotic heart disease is the cause of death for patients with cardiovascular disease worldwide, among which acute ST-segment elevation myocardial infarction (STEMI) is the most lethal. Percutaneous coronary intervention (PCI), if performed in a timely fashion, is the recommended reperfusion strategy for most patients with STEMI. However, some patients still cannot get sufficient blood perfusion after PCI, which is closely related to the subsequent poor clinical prognosis. This situation is called no-reflow phenomenon(NRP). Therefore, in order to effectively restore the blood flow of the coronary microcirculation after reperfusion, it is particularly important to prevent the occurrence of coronary artery NRP. This review summarizes the definition, diagnosis and clinical manifestations of NRP. It also proposes that prevention and treatment strategies can be selected through relevant predictors to improve the efficacy of PCI based on the discussion of its pathophysiological mechanism.